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ACCS EM > Part B 01 > Flashcards

Part B 01 Flashcards

1
Q

LBBB features

A

Qrs>120
Dominant s in V1
L axis deviation
Delayed 1st seg QR

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2
Q

RBBB features

A

> 120ms qrs
RSR pattern in v1-3 (m)
Wide S wave

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3
Q

Heat stroke definition

A

> 40c and CNS dys

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4
Q

Asthma ABG only if

A

sO2 under 92%

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5
Q

Lithotripsy when

A

Stone under 1cm diameter

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6
Q

Staghorn calculus made from

A

Struvite

Mg ammonium phosphate

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7
Q

GRACE scoring for

A

Mortality UA and Nstemi

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8
Q

Trophoblastic disease includes

A

Molar preg and

Choriocarcinoma

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9
Q

Ranson criteria

A

Acute panc

Wcc>16, age>55, glu>10, ast>250, LDH>350

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10
Q

HHS dx

A

Hyperosm hypergly state

>350mmol osm

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11
Q

CI thrombolysis

Stroke

A

> 4:5h
BP>180/110
Use labetalol/nitrate infusion

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12
Q

Chadsvasc

A 
CHF
HTN
Age>75 score 2
DM
Stroke/tia score 2
Vasc ds
Age 64-75
Sex female 1pt
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13
Q

TCA OD

Sx start after what time

A

1-2h

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14
Q

Syphilis organism

A

Treponema pallidum

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15
Q

Tx syphilis

A

IM Procaine benzylpenicillin

10-14d

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16
Q

Tx chlamydia

A

Doxy

Azithromycin

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17
Q

Ix: microscopy and culture
Chlamydia
Vs
Gonorrhea

A 
Chlamydia:
No organisms, nil culture
Vs 
Gonorrhea 
Diplococci, +ve culture
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18
Q

Reactive arthritis

Aka

A

Reiters syndrome

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19
Q

Reactive arthritis sx

A

Conjunctivitis, iritis
Urethritis, cervicitis
Arthritis

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20
Q

Define preg induced HTN

A

Over 20/40
Over 140/90
Without protein in urine

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21
Q

HELLP define

A

Haemolysis (high LDH)
Elevated liver
Low plt

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22
Q

Complication of HELLP

A

Placental abruption
LF
RF

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23
Q

Rovsings sign

A

Acute appendicitis
Palpate Left
Pain in Right

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24
Q

MET (medical expulsive therapy) renal Stone

A

Alpha blockers or CCB

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25
Q

DC shock energies
Unstable tachy
Broad complex/ AF
A flutter/ narrow complex

A

Broad complex/ AF: 120-150
A flutter/ narrow complex:
70-125J
Then increase

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26
Q

DC shock energies

Unstable tachys

A 
Broad complex/ AF:
120-150
A flutter/ narrow complex:
70-120J
Then increase
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27
Q

High take off

Aka

A

Benign early depolarisation

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28
Q

Cyanide Tx

A

Hydroxycobalamin

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29
Q

Heparin antidote

A

Protamine sulphate

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30
Q

Iron OD

Tx

A

Desfurroxamine

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31
Q

Isoniazid OD

Tx

A

Pyridoxine

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32
Q

Ethylene glycol OD

Tx

A

Ethanol or fomepizole

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33
Q

Methanol OD

Tx

A

Ethanol or fomepizole

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34
Q

Ethylene glycol/ methanol OD Tx

A

Ethanol or fomepizole

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35
Q

Organophosphate OD

Tx

A

Atropine

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36
Q

Thallium OD

Tx

A

Prussian blue

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37
Q

Salicylate OD Tx

A

1.26% sodium bicarbonate

38
Q

Calculate anion gap

A

Na - (Cl + HCO3)

39
Q

Normal anion gap

Value

40
Q

High anion gap value

A

~>15mmol

Some sources suggest over 11

41
Q

Causes of high anion gap acidosis

A 
Catmudpiles 
CO
Alcoholic ketoacidosis
Toluene
Metformin/ methanol
Uraemia
DKA
Propelyne glycol
Iron/ isoniazid
Lactic acidosis
Ethylene glycol
Salicylate
42
Q

Torsade de pointe

Tx

A

IV mg sulphate

43
Q

Torsade de pointe

Caused by

44
Q

Hypothermia arrest

Changes to ALS

A

Check SOL for 1 minute
Avoid drugs or defib until over 30C
Double interval between drugs until nearing normothermia

45
Q

Endocarditis Tx

A

Fluclox and gent
If pen allergic/ cardiac prosthesis or suspect MRSA:
Vanc, rifampicin, Gent

46
Q

Steven Johnson’s syndrome

Drugs and interval between taking and onset

A

Most Abx and NSAIDS

Starts 1-3w after initiating drug

47
Q

Wernickes encephalopathy
V
Korsakoffs psychosis
(Order events)

A 
1st; Wernickes encephalopathy
(Conf, ophthal, ataxia)
V
2nd; Korsakoffs psychosis 
(Confab, retrograde amnesia)
48
Q

Diagnosis criteria

Somatization disorder

A 
Any 2:
Pain in 4 different sites
2 GI problems
1 sexual problem
1 pseudo neurological
49
Q

Section 2

A

28d long

Tx mental health disorder and sequela

50
Q

Section 5 (2)

A

72h detain

For MHA assessment

51
Q

Section 136

A

Police detain for 72h ?24h
For MHA assessment
From public place to place of safety

52
Q

Gout crystals appearance

A

Negatively berefringent

53
Q

Ulnar/ medial border snuff box

A

Extensor pollicis longus

54
Q

C-spine CT criteria

A 
GCS<13
Intubated
X-ray inadequate
XR abnormal 
CT of head as well
Or
Alert with clinical suspicion and
Over 65/ dangerous mech/ focal neuro/ paraesthesia/ >5stairs/ >1m/ axial load/ high speed/ roll over RTA/ ejection/ bicycle
55
Q

Conscious sedation advice

A 
Do not:
Drive 
Operate machinery
Make important decisions 
Drink for 24h
56
Q

CT head criteria

A 
GCS <13 on initial assessment 
GCS<15 2h after injury 
D. Skull #, basal skull #
Post traumatic seizure 
Focal deficit 
>1 vomit
57
Q

Dissection

Stanford classification.

A

A: ascending aorta -> surgery
B: not ascending -> medical management

58
Q

Medical management aortic dissection

A

BP control

Labetolol infusion

59
Q

Causes of

Prolonged QT

A

MI
Electrolyte disturbance
Congenital: Romano ward syndrome
Drugs

60
Q

CAST #

A

Childhood associated spiral tibial #

Spiral # distal third

61
Q

Concerning inter arm BP difference

62
Q

Calculate serum osmolality

A

2(k+Na) + urea + glucose

63
Q

Diagnosis HHS

A

Hyperosmotic hyperglycaemic state

Serum osm > 350mmol

64
Q

Substance to test for ketones

A

3B hydroxybutyrate

65
Q

Treatment of HHS

A

Fluids

Ketone >1 -> start insulin

66
Q

Causes of split S1

A

RBBB
LV pacing
Ebstein abnormality

67
Q

DVLA on IDDM

Includes

A

BG prior to journey w/i 2h

BG every 2h whilst driving

68
Q

Allowed to breach confidentiality if:

A 
Legal obligation: notifiable ds 
Court order
Risk to public
Risk to other
Requirement of body (DVLA)
69
Q

Pregnancy and flying

A

Single preg <36/40

Multiple <32/40

70
Q

Fitness to fly certificate
In pregnancy
When required and what to write

A

> 28/40
Write :
Normal preg, no comps, due date

71
Q

To take consent for procedure

You must have

A

Training for consent
Knowledge of procedure
Understand risk/benefit

72
Q

Echo de la pensee
Seen in
Aka

A

Thought echo

Seen in schizophrenia

73
Q

Sad persons score and management

A

0-5: ?safe discharge
6-8: ?psych consultation
>8: ?hosp admission

74
Q

Sad persons

Criteria

A 
Sex: male 
Age <25>59
Depression (2)
Previous attempt or psych care
Etoh/drugs
Rational thinking loss (2)
Single 
Organised attempt (2)
No social input 
Stated future intent (2)
75
Q

Cardiac tamponade signs

A

Becks triad
Distended neck veins
Muffled HS
Hypotension

76
Q

Posterior dislocation shoulder

How

A

Forced posterior

In internal rotation and abduction

77
Q

Complication

Posterior dis shoulder

A

Revere hill Sachs
Reverse bankart lesion
HAGL lesion
#lesser tuberosity

78
Q

HAGL lesion

A

Comp post dislocation shoulder

Humeral avulsion glenohumeral lig

79
Q

Pulled elbow

What structures effected

A

Subluxed radial head
At proximal radioulnar joint
Torn annular lig

80
Q

Manipulation

Pulled elbow

A

2 methods

1) hyperpronation
2) supination and flexion

81
Q

Posterolateral elbow dislocation

Complications

A

Ulnar/ median nerve
Brachial artery
Medial epicondyle #

82
Q

Posterolateral elbow dislocation

Manipulation

A

Pronate
Flex at 60 deg
Pull

83
Q

Levels of sedation

ASA

A

Minimal: anxiolysis
Moderate: conscious sedation: respond voice
Deep: painful stimuli
General anaesthesia: unrousable

84
Q

Deep sedation

monitoring

A

ECG
NIBP
Pulse ox
Capnography

85
Q

Dry socket syndrome

Aka

A

Alveolar osteitis

86
Q

Trauma chest drain

Size

87
Q

Optimal chest drain site

A

5th intercostal space

Anterior to mid axillary line

88
Q

Tetanus Ig

Give if

A

High risk wound and
Unknown immunisation
Under 3 doses vaccine
>5 yrs since last dose

89
Q

Tetanus Ig dose

A

250-500 IU

90
Q

Flaccid
Vs
Spastic bladder

A

Flaccid: T12
“Reflex bladder”
Cannot sense filling, but reflex emptying

91
Q

Mannitol dose

92
Q

Mannitol

Used to Tx

A

High ICP
Glaucoma
Diuretic
Rhabdomyolysis

ACCS EM (11 decks)

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